SPH at the hemodynamic, vascular level. Simplified
scheme of the hepatic vascular architecture and conditions that result in
elevated SP (SP) and liver stiffness (LS). SP and LS are shown as consequence of
the various inflow (red circles) and outflow balances (black circles) in a
schematized vascular architecture of the liver. Intrahepatic or extrahepatic
shunts (white circles) will also affect SP in a complex manner and, according to
SPH, will also have an important impact on the development of portal
hypertension and liver function. According to SPH, M1 (stiff livers with good
liver function) and M2 (soft liver with poor liver function) can be postulated
for cirrhotics based on intrahepatic shunt
formation. Red arrows: flow direction, HABR: hepatic arterial buffer response